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Christer Mjåset: 4 questions you should always ask your doctor
Christer Mjåset: 4 pitanja koja uvijek morate pitati svog liječnika
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"Doktore, je li to zaista nužno?" Uz pomoć zapanjujuće statistike o prekomjernom liječenju, neurokirurg Christer Mjåset objašnjava moć ovog i drugih jednostavnih pitanja u kontekstu medicinskih tretmana i kirurških zahvata - i govori kako pacijenti mogu bolje raditi s liječnicima kako bi dobili skrb koja im je potrebna.
Christer Mjåset - Neurosurgeon
Christer Mjåset, M.D. is a neurosurgeon, author, columnist and lecturer who currently works as a Harkness fellow in Health Care Policy and Practice at Harvard T.H. Chan School of Public Health in Boston studying value-based health care models. Full bio
Christer Mjåset, M.D. is a neurosurgeon, author, columnist and lecturer who currently works as a Harkness fellow in Health Care Policy and Practice at Harvard T.H. Chan School of Public Health in Boston studying value-based health care models. Full bio
Double-click the English transcript below to play the video.
00:12
I am a neurosurgeon,
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Ja sam neurokirurg
00:15
and I'm here to tell you today
that people like me need your help.
that people like me need your help.
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i danas sam ovdje kako bih vam rekao
da ljudi poput mene trebaju vašu pomoć.
da ljudi poput mene trebaju vašu pomoć.
00:20
And in a few moments, I will tell you how.
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I za tren ću vam reći kako.
00:22
But first, let me start off by telling you
about a patient of mine.
about a patient of mine.
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No, prvo, dozvolite da vam kažem nešto
o jednom svom pacijentu.
o jednom svom pacijentu.
00:26
This was a woman in her 50s,
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To je bila žena u pedesetima,
00:28
she was in generally good shape,
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općenito je bila u dobroj formi,
00:31
but she had been in and out
of hospital a few times
of hospital a few times
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ali je u nekoliko navrata
boravila u bolnici
boravila u bolnici
00:33
due to curative breast cancer treatment.
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zbog liječenja raka dojke.
00:37
Now she had gotten a prolapse
from a cervical disc,
from a cervical disc,
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Ovog puta imala je prolaps vratnog diska,
00:40
giving her radiating pain of a tense kind,
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što joj je uzrokovalo isijavajuću bol
u vidu napetosti
u vidu napetosti
00:44
out into the right arm.
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koja se širila u desnu ruku.
00:47
Looking at her MRI
before the consultation,
before the consultation,
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Pogledavši njenu MR snimku
prije konzultacije,
prije konzultacije,
00:49
I decided to suggest an operation.
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odlučio sam predložiti operaciju.
00:52
Now, neck operations like these
are standardized, and they're quick.
are standardized, and they're quick.
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Operacije vrata poput te,
standardizirane su i brze,
standardizirane su i brze,
00:57
But they carry a certain risk.
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ali nose određeni rizik.
00:58
You make an incision right here,
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Napravite rez upravo ovdje
01:01
and you dissect carefully
past the trachea,
past the trachea,
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i pažljivo secirate duž dušnika,
01:03
the esophagus,
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jednjaka,
01:05
and you try not to cut
into the internal carotid artery.
into the internal carotid artery.
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i nastojite da ne zarežete
unutarnju vratnu arteriju.
unutarnju vratnu arteriju.
01:08
(Laughter)
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(Smijeh)
01:09
Then you bring in the microscope,
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Onda uvučete mikroskop
01:12
and you carefully remove
the disc and the prolapse
the disc and the prolapse
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i pažljivo uklonite disk i prolaps
u kanalu korijena živca
01:14
in the nerve root canal,
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tako da ne oštetite moždinu
i korijen živca
i korijen živca
01:15
without damaging the cord
and the nerve root
and the nerve root
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01:17
lying only millimeters underneath.
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koji se nalaze samo par milimetara ispod.
Scenarij najgoreg slučaja
je oštećenje leđne moždine,
je oštećenje leđne moždine,
01:20
The worst case scenario
is the damage to the cord,
is the damage to the cord,
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01:23
which can result in paralysis
from the neck down.
from the neck down.
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što može rezultirati paralizom
od vrata naniže.
od vrata naniže.
01:28
Explaining this to the patient,
she fell silent.
she fell silent.
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Objasnivši to pacijentici,
ona je zanijemila.
ona je zanijemila.
01:31
And after a few moments,
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I nakon nekoliko trenutaka
01:32
she uttered a few very decisive words
for me and for her.
for me and for her.
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izustila je svega nekoliko riječi
koje su bile odlučne za mene i nju.
koje su bile odlučne za mene i nju.
01:37
"Doctor, is this really necessary?"
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"Doktore, je li to zaista nužno?"
01:41
(Laughter)
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(Smijeh)
01:44
And you know what I realized,
right there and then?
right there and then?
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I znate li što sam shvatio
upravo u tom trenutku?
upravo u tom trenutku?
01:47
It was not.
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Nije bilo nužno.
01:49
In fact, when I get patients
like this woman,
like this woman,
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Ustvari, kada mi dođu pacijenti
poput te žene,
poput te žene,
01:52
I tend to advise not to operate.
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nisam sklon savjetovati operaciju.
01:55
So what made me do it this time?
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Pa što me onda nagnalo na to ovaj put?
01:59
Well, you see,
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Pa, vidite,
02:00
this prolapse was so delicate,
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taj prolaps je bio tako delikatan,
02:03
I could practically see myself
pulling it out of the nerve root canal
pulling it out of the nerve root canal
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mogao sam praktički vidjeti sebe
kako ga izvlačim iz kanala korijena živca
kako ga izvlačim iz kanala korijena živca
02:06
before she entered the consultation room.
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i prije no što je ušla u ordinaciju.
02:09
I have to admit it,
I wanted to operate on her.
I wanted to operate on her.
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Moram priznati, želio sam je operirati.
02:13
I'd love to operate on her.
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Volio bih je operirati.
02:15
Operating, after all,
is the most fun part of my job.
is the most fun part of my job.
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Operiranje je, na koncu,
najzabavniji dio mog posla.
najzabavniji dio mog posla.
02:18
(Laughter)
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(Smijeh)
02:22
I think you can relate to this feeling.
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Mislim da možete shvatiti taj osjećaj.
02:24
My architect neighbor says
he loves to just sit and draw
he loves to just sit and draw
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Moj susjed, arhitekt, kaže
da voli samo sjesti i crtati
da voli samo sjesti i crtati
02:28
and design houses.
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i dizajnirati kuće.
02:30
He'd rather do that all day
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Radije bi to radio cijeli dan
02:31
than talk to the client
paying for the house
paying for the house
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nego razgovarao s klijentom
koji plaća za kuću
koji plaća za kuću
02:35
that might even give him
restrictions on what to do.
restrictions on what to do.
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i koji bi mu čak mogao
zadati ograničenja za ono što radi.
zadati ograničenja za ono što radi.
02:39
But like every architect,
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No, kao i svaki arhitekt,
02:40
every surgeon needs
to look their patient in the eye
to look their patient in the eye
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svaki kirurg mora pogledati
svog pacijenta u oči
svog pacijenta u oči
02:43
and together with the patient,
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i zajedno s pacijentom
02:44
they need to decide on what is best
for the person having the operation.
for the person having the operation.
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odlučiti što je najbolje
za osobu koja se operira.
za osobu koja se operira.
02:50
And that might sound easy.
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A to možda zvuči lako.
02:51
But let's look at some statistics.
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No, pogledajmo par statistika.
02:56
The tonsils are the two lumps
in the back of your throat.
in the back of your throat.
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Krajnici su dvije izrasline
na stražnjoj strani grla.
na stražnjoj strani grla.
02:59
They can be removed surgically,
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Mogu se kirurški odstraniti,
03:01
and that's called a tonsillectomy.
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i to se zove tonzilektomija.
03:03
This chart shows the operation rate
of tonsillectomies in Norway
of tonsillectomies in Norway
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Ovaj graf prikazuje stopu operacija
tonzilektomije u Norveškoj
tonzilektomije u Norveškoj
03:07
in different regions.
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u različitim regijama.
03:09
What might strike you
is that there is twice the chance
is that there is twice the chance
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Možda će vas iznenaditi
da je duplo veća šansa
da je duplo veća šansa
03:13
that your kid --
because this is for children --
because this is for children --
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da će vaše dijete --
jer ovo se odnosi na djecu --
jer ovo se odnosi na djecu --
03:16
will get a tonsillectomy in Finnmark
than in Trondheim.
than in Trondheim.
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proći tonzilektomiju u Finnmarku
nego u Trondheimu.
nego u Trondheimu.
03:20
The indications
in both regions are the same.
in both regions are the same.
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Indikacije u obje regije su jednake.
03:24
There should be
no difference, but there is.
no difference, but there is.
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Ne bi trebala postojati razlika,
ali postoji.
ali postoji.
03:26
Here's another chart.
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Evo još jednog grafa.
03:28
The meniscus helps stabilize the knee
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Meniskus pomaže stabilizaciji koljena
03:30
and can be torn or fragmented acutely,
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i može biti pokidan
ili akutno fragmentiran,
ili akutno fragmentiran,
03:32
topically during sports like soccer.
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tipično u sportovima kao što je nogomet.
03:35
What you see here is the operation rate
for this condition.
for this condition.
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Ono što ovdje vidite je
stopa operacija za to stanje.
stopa operacija za to stanje.
03:39
And you see that the operation
rate in Møre og Romsdal
rate in Møre og Romsdal
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I vidite da je stopa operacija
u regiji Møre og Rosdal
u regiji Møre og Rosdal
03:43
is five times the operation
rate in Stavanger.
rate in Stavanger.
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pet puta veća od
stope operacija u Stavangeru.
stope operacija u Stavangeru.
03:47
Five times.
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Pet puta.
03:49
How can this be?
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Kako to može biti?
Igraju li nogometaši
u Møre og Romsdalu prljaviju igru
u Møre og Romsdalu prljaviju igru
03:50
Did the soccer players in Møre og Romsdal
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03:52
play more dirty
than elsewhere in the country?
than elsewhere in the country?
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nego u drugim dijelovima zemlje?
03:54
(Laughter)
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(Smijeh)
03:56
Probably not.
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Vjerojatno ne.
03:59
I added some information now.
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Sad sam dodao još neke informacije.
04:01
What you see now
is the procedures performed
is the procedures performed
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Ono što sada vidite su operacije izvršene
04:03
in public hospitals, in light blue,
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u javnim bolnicama, svjetloplavo,
04:05
the ones in private clinics
are light green.
are light green.
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one u privatnim klinikama
su svjetlozelene.
su svjetlozelene.
04:08
There is a lot of activity
in the private clinics
in the private clinics
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Mnogo je aktivnosti u privatnim klinikama
04:11
in Møre og Romsdal, isn't there?
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u Møre og Romsdalu, zar ne?
04:14
What does this indicate?
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Na što to ukazuje?
04:15
A possible economic motivation
to treat the patients.
to treat the patients.
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Moguću ekonomsku motivaciju
za liječenje pacijenata.
za liječenje pacijenata.
04:20
And there's more.
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A ima još toga.
04:23
Recent research has shown
that the difference of treatment effect
that the difference of treatment effect
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Najnovija istraživanja pokazuju
da razlika u učinkovitosti tretmana
da razlika u učinkovitosti tretmana
04:27
between regular physical therapy
and operations for the knee --
and operations for the knee --
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između redovne fizikalne terapije
i operacije koljena --
i operacije koljena --
04:30
there is no difference.
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nema razlike.
04:32
Meaning that most
of the procedures performed
of the procedures performed
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Što znači da je većina
obavljenih operacija,
obavljenih operacija,
04:36
on the chart I've just shown
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na grafu koji sam upravo pokazao,
04:38
could have been avoided,
even in Stavanger.
even in Stavanger.
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mogla biti izbjegnuta,
čak i u Stavangeru.
čak i u Stavangeru.
04:41
So what am I trying to tell you here?
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Dakle, što vam ovime pokušavam reći?
04:44
Even though most indications
for treatments in the world
for treatments in the world
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Unatoč tome što je u svijetu
većina indikacija za liječenje
većina indikacija za liječenje
04:49
are standardized,
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standardizirana,
04:50
there is a lot of unnecessary variation
of treatment decisions,
of treatment decisions,
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postoji mnogo nepotrebnih varijacija
u odlukama o liječenju,
u odlukama o liječenju,
04:54
especially in the Western world.
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posebno u zapadnom svijetu.
04:57
Some people are not getting
the treatment that they need,
the treatment that they need,
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Neki ljudi ne dobivaju tretman
koji im je potreban,
koji im je potreban,
05:01
but an even greater portion of you
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ali još veći dio vas
05:04
are being overtreated.
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je previše tretiran.
05:08
"Doctor, is this really necessary?"
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"Doktore, je li to zaista nužno?"
05:11
I've only heard that question
once in my career.
once in my career.
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To sam pitanje čuo samo jednom
u svojoj karijeri.
u svojoj karijeri.
05:14
My colleagues say they never heard
these words from a patient.
these words from a patient.
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Moji kolege kažu da nikada
nisu čuli te riječi od pacijenta.
nisu čuli te riječi od pacijenta.
A da to preokrenemo:
05:19
And to turn it the other way around,
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što mislite koliko puta
bi vam liječnik odgovorio "Ne"
bi vam liječnik odgovorio "Ne"
05:21
how often do you think
you'll get a "no" from a doctor
you'll get a "no" from a doctor
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05:23
if you ask such a question?
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kad biste mu postavili takvo pitanje?
05:26
Researchers have investigated this,
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Znanstvenici su to istraživali
05:28
and they come up
with about the same "no" rate
with about the same "no" rate
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i došli su do otprilike iste stope
za odgovor "Ne"
za odgovor "Ne"
05:30
wherever they go.
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kojim god putem krenuli.
05:32
And that is 30 percent.
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A to je 30 posto.
05:33
Meaning, three out of 10 times,
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Što znači, u tri od deset slučajeva
05:37
your doctor prescribes
or suggests something
or suggests something
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vaš liječnik propisuje ili predlaže nešto
05:41
that is completely unnecessary.
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što je potpuno nepotrebno.
05:46
And you know what they claim
the reason for this is?
the reason for this is?
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A znate li što tvrde da je tome razlog?
05:50
Patient pressure.
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Pritisak pacijenta.
05:52
In other words, you.
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Drugim riječima, vi.
05:54
You want something to be done.
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Vi želite da se nešto učini.
05:58
A friend of mine came to me
for medical advice.
for medical advice.
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Jedan moj prijatelj obratio mi se
za medicinski savjet.
za medicinski savjet.
06:01
This is a sporty guy,
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To je sportski momak,
06:02
he does a lot of cross-country skiing
in the winter time,
in the winter time,
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mnogo se bavi cross-country
skijanjem zimi,
skijanjem zimi,
06:05
he runs in the summer time.
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ljeti trči.
06:07
And this time, he'd gotten a bad back ache
whenever he went jogging.
whenever he went jogging.
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A ovoga puta je imao ozbiljne
bolove u leđima kad god je džogirao.
bolove u leđima kad god je džogirao.
Toliko jako da je morao prestati s tim.
06:11
So much that he had to stop doing it.
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06:15
I did an examination,
I questioned him thoroughly,
I questioned him thoroughly,
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Ja sam ga pregledao, temeljito ga ispitao,
06:18
and what I found out is
that he probably had a degenerated disc
that he probably had a degenerated disc
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i ustanovio sam da vjerojatno ima
degeneraciju diska
degeneraciju diska
06:21
in the lower part of his spine.
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u donjem dijelu kralježnice.
06:24
Whenever it got strained, it hurt.
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Kad god je napregnuta, to boli.
06:28
He'd already taken up
swimming instead of jogging,
swimming instead of jogging,
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On je već počeo s plivanjem
umjesto džogiranja,
umjesto džogiranja,
stvarno se ništa nije moglo učiniti,
06:30
there was really nothing to do,
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pa sam mu rekao,"Moraš biti selektivniji
06:32
so I told him, "You need
to be more selective
to be more selective
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kad je u pitanju vježbanje.
06:34
when it comes to training.
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Neke aktivnosti su dobre za tebe,
06:35
Some activities are good for you,
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06:37
some are not."
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neke nisu."
06:39
His reply was,
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Njegov je odgovor bio,
06:41
"I want an MRI of my back."
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"Želim magnetsku rezonanciju leđa."
06:45
"Why do you want an MRI?"
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"Zašto želiš MR?"
06:48
"I can get it for free
through my insurance at work."
through my insurance at work."
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"Mogu to dobiti besplatno preko
svog osiguranja na poslu."
svog osiguranja na poslu."
06:51
"Come on," I said --
he was also, after all, my friend.
he was also, after all, my friend.
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"Ma, hajde," rekao sam --
na koncu, bio mi je i prijatelj.
na koncu, bio mi je i prijatelj.
06:54
"That's not the real reason."
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"To nije pravi razlog."
06:56
"Well, I think it's going to be good
to see how bad it looks back there."
to see how bad it looks back there."
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"Pa, mislim da bi bilo dobro
vidjeti koliko loše izgleda to odostraga."
vidjeti koliko loše izgleda to odostraga."
07:03
"When did you start interpreting
MRI scans?" I said.
MRI scans?" I said.
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"Otkada si ti počeo
tumačiti MR snimke?", rekao sam.
tumačiti MR snimke?", rekao sam.
07:06
(Laughter)
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(Smijeh)
07:08
"Trust me on this.
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"Vjeruj mi,
07:10
You're not going to need the scan."
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neće ti trebati to snimanje."
07:12
"Well," he said,
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"Pa," rekao je on,
07:14
and after a while, he continued,
"It could be cancer."
"It could be cancer."
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i nakon nekog vremena nastavio,
"mogao bi biti rak."
"mogao bi biti rak."
07:17
(Laughter)
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(Smijeh)
07:20
He got the scan, obviously.
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Dobio je taj snimak, očito.
A preko svog osiguranja na poslu,
07:22
And through his insurance at work,
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dobio je pregled kod jednog
od mojih kolega s posla,
od mojih kolega s posla,
07:24
he got to see one
of my colleagues at work,
of my colleagues at work,
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koji mu je rekao za degeneraciju diska,
07:26
telling him about the degenerated disc,
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07:28
that there was nothing to do,
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da se tu ne može ništa
07:30
and that he should keep on swimming
and quit the jogging.
and quit the jogging.
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i da treba nastaviti s plivanjem
i prestati džogirati.
i prestati džogirati.
Nakon nekog vremena
ponovo sam ga sreo i rekao je,
ponovo sam ga sreo i rekao je,
07:36
After a while,
I met him again and he said,
I met him again and he said,
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"Sada bar znam što je to."
07:38
"At least now I know what this is."
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07:40
But let me ask you a question.
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No, dozvolite da vas pitam,
07:42
What if all of you in this room
with the same symptoms had an MRI?
with the same symptoms had an MRI?
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što kad biste svi vi u ovoj dvorani
s istim simptomima otišli na MR?
s istim simptomima otišli na MR?
07:46
And what if all the people in Norway
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I što kad bi svi ljudi u Norveškoj
07:49
had an MRI due to occasional back pain?
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išli na MR zbog povremenih
bolova u leđima?
bolova u leđima?
07:54
The waiting list for an MRI
would quadruple, maybe even more.
would quadruple, maybe even more.
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Lista čekanja na MR
bi se učetvorostručila, možda i više.
bi se učetvorostručila, možda i više.
07:58
And you would all take
the spot on that list
the spot on that list
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A svi biste vi uzeli mjesto na toj listi
08:00
from someone who really had cancer.
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nekom drugom tko stvarno ima rak.
08:03
So a good doctor sometimes says no,
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Zato dobar liječnik ponekad kaže ne,
08:07
but the sensible patient
also turns down, sometimes,
also turns down, sometimes,
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a razuman pacijent
također odbija, ponekad,
također odbija, ponekad,
08:11
an opportunity
to get diagnosed or treated.
to get diagnosed or treated.
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priliku za dijagnozu i liječenje.
08:16
"Doctor, is this really necessary?"
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"Doktore, je li to zaista nužno?"
08:20
I know this can be
a difficult question to ask.
a difficult question to ask.
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Znam da može biti teško
postaviti to pitanje.
postaviti to pitanje.
Ustvari, ako se vratite 50 godina unatrag,
08:24
In fact, if you go back 50 years,
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08:26
this was even considered rude.
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to se čak smatralo nepristojnim.
08:28
(Laughter)
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(Smijeh)
08:29
If the doctor had decided
what to do with you,
what to do with you,
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Ako je liječnik odlučio
što učiniti s vama,
što učiniti s vama,
08:32
that's what you did.
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to ste i učinili.
08:35
A colleague of mine,
now a general practitioner,
now a general practitioner,
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Jedna moja kolegica,
liječnica opće medicine,
liječnica opće medicine,
08:37
was sent away to a tuberculosis
sanatorium as a little girl,
sanatorium as a little girl,
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bila je, kao mala djevojčica, poslana
u sanatorij za liječenje tuberkuloze
u sanatorij za liječenje tuberkuloze
08:42
for six months.
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na šest mjeseci.
08:43
It was a terrible trauma for her.
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To je za nju bila užasna trauma.
08:45
She later found out, as a grown-up,
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Kasnije je otkrila, kao odrasla,
08:48
that her tests on tuberculosis
had been negative all along.
had been negative all along.
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da su njeni testovi na tuberkulozu
cijelo vrijeme bili negativni.
cijelo vrijeme bili negativni.
08:52
The doctor had sent her away
on nothing but wrong suspicion.
on nothing but wrong suspicion.
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Liječnik ju je poslao samo na temelju
svoje pogrešne sumnje.
svoje pogrešne sumnje.
08:56
No one had dared or even considered
confronting him about it.
confronting him about it.
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Nitko se nije usuđivao
proturječiti mu u tome.
proturječiti mu u tome.
09:01
Not even her parents.
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Čak ni njeni roditelji.
09:03
Today, the Norwegian health minister
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Danas, norveški ministar zdravstva
09:06
talks about the patient
health care service.
health care service.
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govori o zdravstvenoj usluzi pacijenata.
09:10
The patient is supposed to get advice
from the doctor about what to do.
from the doctor about what to do.
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Pacijent bi trebao dobiti savjet
od liječnika o tome što učiniti.
od liječnika o tome što učiniti.
09:16
This is great progress.
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To je veliki napredak.
09:18
But it also puts more
responsibility on you.
responsibility on you.
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Ali to također prenosi
više odgovornosti na vas.
više odgovornosti na vas.
09:21
You need to get in the front seat
with your doctor
with your doctor
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Vi morate sjesti sa svojim liječnikom
09:24
and start sharing
decisions on where to go.
decisions on where to go.
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i početi dijeliti odluke o tome
kojim smjerom krenuti.
kojim smjerom krenuti.
09:27
So, the next time
you're in a doctor's office,
you're in a doctor's office,
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Pa sljedeći puta kada budete
u liječničkoj ordinaciji,
u liječničkoj ordinaciji,
09:31
I want you to ask,
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želim da ga upitate,
09:32
"Doctor, is this really necessary?"
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"Doktore, je li to zaista nužno?"
09:36
And in my female patient's case,
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A u slučaju moje pacijentice,
09:38
the answer would be no,
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odgovor bi bio 'nije'.
09:40
but an operation could also be justified.
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Ali i operacija bi također
mogla biti opravdana.
mogla biti opravdana.
09:44
"So doctors, what are the risks
attached to this operation?"
attached to this operation?"
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"Doktore, koji su rizici
povezani s tom operacijom?"
povezani s tom operacijom?"
09:49
Well, five to ten percent of patients
will have worsening of pain symptoms.
will have worsening of pain symptoms.
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Pa, pet do deset posto pacijenata
će imati pogoršanje bolnih simptoma.
će imati pogoršanje bolnih simptoma.
09:55
One to two percent of patients
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Jedan do dva posto pacijenata
09:57
will have an infection in the wound
or even a rehemorrhage
or even a rehemorrhage
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imat će infekciju rane ili čak hemoragiju
10:00
that might end up in a re-operation.
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koja može završiti ponovnom operacijom.
10:04
0.5 percent of patients
also experience permanent hoarseness
also experience permanent hoarseness
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0,5 posto pacijenata
će osjećati stalnu promuklost,
će osjećati stalnu promuklost,
10:07
and a few, but still a few,
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a nekoliko, ali samo nekoliko,
10:09
will experience reduced function
in the arms or even legs.
in the arms or even legs.
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doživjet će smanjenu
funkciju ruku ili čak nogu.
funkciju ruku ili čak nogu.
10:15
"Doctor, are there other options?"
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"Doktore, postoje li druge opcije?"
10:18
Yes, rest and physical therapy
over some time
over some time
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Da, odmor i fizikalna terapija
tijekom nekog vremena
tijekom nekog vremena
10:21
might get you perfectly well.
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mogli bi dovesti do potpunog oporavka.
10:25
"And what happens if I don't do anything?"
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"A što se događa ako ne učinim ništa?"
10:27
It's not recommended,
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To nije preporučljivo,
10:29
but even then, there's a slight chance
that you will get well.
that you will get well.
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no čak i tada postoji mala nada
da ćete se oporaviti.
da ćete se oporaviti.
10:33
Four questions.
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Četiri pitanja.
10:34
Simple questions.
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Jednostavna pitanja.
10:36
Consider them your new toolbox to help us.
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Smatrajte ih svojim novim alatom
kojim ćete nam pomoći.
kojim ćete nam pomoći.
10:40
Is this really necessary?
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Je li to zaista nužno?
10:42
What are the risks?
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Koji su rizici?
10:44
Are there other options?
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Postoje li druge opcije?
10:45
And what happens if I don't do anything?
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I što se događa ako ne učinim ništa?
10:49
Ask them when your doctor
wants to send you to an MRI,
wants to send you to an MRI,
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Upitajte ih kada vas vaš doktor
želi poslati na MR,
želi poslati na MR,
10:53
when he prescribes antibiotics
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kad prepisuje antibiotike
10:55
or suggests an operation.
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ili predlaže operaciju.
10:58
What we know from research
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Ono što znamo iz istraživanja
11:00
is that one out of five
of you, 20 percent,
of you, 20 percent,
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je da će jedan između petoro vas,
20 posto,
11:03
will change your opinion on what to do.
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promijeniti svoje mišljenje
o tome što učiniti.
o tome što učiniti.
11:06
And by doing that, you will
not only have made your life
not only have made your life
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A učinivši to, ne samo da ćete
svoj život učiniti mnogo lakšim,
svoj život učiniti mnogo lakšim,
11:09
a whole lot easier,
and probably even better,
and probably even better,
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a vjerojatno čak i boljim,
11:13
but the whole health care sector
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nego će i cijeli sektor zdravstva
imati koristi od vaše odluke.
imati koristi od vaše odluke.
11:15
will have benefited from your decision.
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11:19
Thank you.
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Hvala.
11:20
(Applause)
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(Pljesak)
ABOUT THE SPEAKER
Christer Mjåset - NeurosurgeonChrister Mjåset, M.D. is a neurosurgeon, author, columnist and lecturer who currently works as a Harkness fellow in Health Care Policy and Practice at Harvard T.H. Chan School of Public Health in Boston studying value-based health care models.
Why you should listen
Christer Mjåset, M.D. holds a position as a researcher at the Oslo University Hospital analyzing data from The Norwegian Spine Registry and as a lecturer at the Department of Health Management and Economics, University of Oslo, where he teaches in a leadership program for young physicians. Mjåset was president of the Norwegian Junior Doctors 2015-2019 and the Vice President of the Norwegian Medical Association 2017-2019. This work led him to be involved with the international Choosing Wisely campaign which seeks to advance a national dialogue avoiding unnecessary medical tests, treatments and procedures. From 2017-2019 he was responsible for implementing the campaign in Norway
Mjåset is a published author of five fictional books and several short stories. He won the Oslo City Cultural Scholarship for writers in 2006. He got his medical degree and bachelor’s degree in literature and philosophy at University of Oslo, both in 2000.
Christer Mjåset | Speaker | TED.com